1. Field Of The Invention
The invention relates to accessory devices and systems for use with beds adapted to support patients in a partial sitting (i.e., head elevated from the horizontal) position. More particularly, the invention relates to devices and systems for maintaining the position and alignment of patients confined to elevated head type beds over long periods of time.
2. Summary Of The Prior Art
Patients confined to bed for long periods of time, whether in a hospital, an extended care facility or at home, usually utilize a bed which is articulatable so as to place the patient in a partial sitting (i.e., head elevated above the horizontal) position. Unless contra-indicated medically, the partial sitting position is generally the most comfortable for the patient and the most convenient for the caregiver. Specifically, the partial sitting position facilitates the conduct of activities by the patient such as reading, eating, watching television and conversing with visitors. It also facilitates caregiver access to the patient for both medical and hygenic reasons. Indeed, in many cases, the patient by choice remains in the partial sitting position both during the day and at night. There are problems, however.
Bedridden patients are subject to a condition known as foot drop wherein the foot tends to assume a more or less permanent pointed toe configuration. This condition is the result of a combination of a lack of support for the patient's feet and the substantially constant pressure exerted by the bed linen covering them. It is particularly evident in extremely ill patients who for one reason or another are not only confined to bed, but also are limited to lying on their backs.
Relatedly, there is a tendency for patients confined to head elevated type beds to slide towards the foot of the bed when the head of the bed is elevated in order to place the patient in a partial sitting position. This is a serious problem because once a seriously ill patient has slid out of his preferred position and alignment in the bed, it is frequently impossible for him to reposition himself. Accordingly, it falls to the caregiver to assist, and in some cases totally accomplish, the required repositioning. This process can be painful for the patient, particularly if large incisions are involved, and the source of strain and stress upon the caregiver. The repositioning of a patient typically requires that the patient be lowered to a horizontal position, pulled toward the head of the bed and then again elevated to the partial sitting position. Hence, it will be understood that the process is physically demanding, and requires the attention of the caregiver for an extended period when that time might be better spent attending to the medical needs of other patients.
In an attempt to alleviate the foot drop problem, various types of footboards have been provided. The simplest of these were plywood constructions which were slipped under the mattress at the foot end of the bed. These devices were crude in construction and heavy. Further, these wooden constructions were often unfinished, thereby leading to cuts and/or to the pick up of splinters by those attempting to position them. Other types of footboards also have been proposed. Typically, these are metallic constructions which hook over the bedframe at the foot end of the bed or ride on specialized rails located along the sides of the bed. These devices had a limited range of adjustment provided by the manipulation of screws and/or levers or by sliding them along the associated rails. Pillows between the patient's feet and the footboard, however, were often required to accurately adjust the bed to fit a particular patient. They also were cumbersome and ineffective. Further, all of these prior footboards tend to interfere with the changing of bed linens.
Another problem encountered in the use of prior art footboards has been that they require the provision of extensive amounts of padding between the patient's feet and the footboard itself. The reason for this is that the foot engaging surface of these boards were hard and unyeilding. Further, gravity tends to pull the patient from the partial sitting position downwardly along the patient supporting surface of the mattress. This motion is resisted by the engagement of the patient's feet with the footboard. The result, however, is that the patient effectively stands on the footboard constantly. Obviously, it does not take too long for the patient's legs and feet to become cramped and uncomfortable. In fact, in some cases actual physical injury to the patient may result from the strain inflicted upon his legs and feet in this manner.
Still further, as alluded to above, it is often preferrable to allow a bedridden patient to reposition himself, if possible. The patient knows where his pain is, and he instinctively knows how to manipulate himself in order to minimize the infliction of additional pain. A caregiver moving a patient, no matter how carefully, cannot duplicate this instinctive knowledge. To facilitate patient self-movement and to minimize caregiver physical strain, therefore, it has been frequently possible for orthopedic patients to grasp frameworks attached to their beds and/or strap devices fastened thereto in order to assist them in changing positions. It is also common for the caregiver to provide a length of stockinette-like material tied at one end to the bedframe at the foot end of the bed such that the free end is available for the patient to grasp to assist him in changing his position in, getting into or getting out of the bed. Obviously, beds with orthopedic appliances attached to them are not common. Further, the stockinette alternative is somewhat makeshift, and is not wholly desirable for safety reasons.